Evaluation of patient’s satisfaction in the surgical units in a tertiary care public hospital

Introduction: In the modern era, it is not only the right of every patient to demand best possible medical care in Government runs Hospitals, but it is the moral and legal obligation of every health care provider as well, to deliver his optimum efforts to the entire satisfaction of the patient. Methods: A pre formed questionnaire and personal interview of 350 patients was carried out to determine the level of satisfaction among patients. Results: Most of the patients were found to be more than satisfied in most of the categories of questions asked. Conclusion: Overall assessment of the whole process through this study gave us an opportunity to find loopholes and deficiencies in our services for any future remedial action. The response given by the patients at the end of the data collected enabled us to make any suggestions so as to improve the quality of the services rendered at the hospital

POLYPHARMACY LEADING TO ADVERSE DRUG REACTIONS IN ELDERLY IN A TERTIARY CARE HOSPITAL

Polypharmacy is a common occurrence in elderly patients due to reasons like multiple co-morbidities and multiple prescribing physicians. The present study was designed to identify the adverse drug reactions occurring in the elderly as a result of polypharmacy and also to assess the rationality of prescription based on World Health Organization (WHO) criteria and Beer’s criteria. This study was conducted at Victoria hospital attached to Bangalore Medical College and Research Institute. Hundred patients aged ≥60 years and prescribed more than 5 drugs were included in the study. The analysis of data revealed, the number of drugs per prescription was 8.42±2.4. Of the total 842 drugs prescribed, number of drugs prescribed by generic name was 36 (4.27%) and number of drugs prescribed from WHO model list of essential medicine was 444 (52.7%). Adverse drug reactions were mainly seen in 15 % of patients. 20 patients were prescribed potentially harmful drugs according to Beer’s list. To conclude, polypharmacy was seen in majority of elderly patients but the use of injections and antibiotics were limited. Prescribing by generic name and from essential drug list needs to be improved. Many ADRs were noted for commonly prescribed drugs and also for inappropriate drugs as given in Beer’s list

Clinical phenotype and the lack of mutations in the CHRNG, CHRND, and CHRNA1 genes in two Indian families with Escobar syndrome

The objective of this study was to report the clinical phenotype and genetic analysis of two Indian families with Escobar syndrome (ES). The diagnosis of ES in both families was made on the basis of published clinical features. Blood samples were collected from members of both families and used in genomic DNA isolation. The entire coding regions and intron-exon junctions of the ES gene CHRNG (cholinergic receptor, nicotinic, gamma), and two other related genes, CHRND and CHRNA1, were amplified and sequenced to search for mutations in both families. Both families show a typical form of ES. Sequencing of the entire coding regions including the intron-exon junctions of the three genes did not yield any mutations in these families. In conclusion, it is possible that the mutations in these genes are located in the promoter or deep intronic regions that we failed to identify or the ES in these families is caused by mutations in a different gene. The lack of mutations in CHRNG has also been reported in several families, suggesting the possibility of at least one more gene for this syndrome. Clin Dysmorphol 22:54-58 (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

A homozygous mutation in TRIM36 causes autosomal recessive anencephaly in an Indian family

Anencephaly (APH) is characterized by the absence of brain tissues and cranium. During primary neurulation stage of the embryo, the rostral part of the neural pore fails to close, leading to APH. APH shows a heterogeneous etiology, ranging from environmental to genetic causes. The autosomal recessive inheritance of APH has been reported in several populations. In this study, we employed whole-exome sequencing and identified a homozygous missense mutation c. 1522C > A (p. Pro508Thr) in the TRIM36 gene as the cause of autosomal recessive APH in an Indian family. The TRIM36 gene is expressed in the developing brain, suggesting a role in neurogenesis. In silico analysis showed that proline at codon position 508 is highly conserved in 26 vertebrate species, and the mutation is predicted to affect the conformation of the B30.2/SPRY domain of TRIM36. Both in vitro and in vivo results showed that the mutation renders the TRIM36 protein less stable. TRIM36 is known to associate with microtubules. Transient expression of the mutant TRIM36 in HeLa and LN229 cells resulted in microtubule disruption, disorganized spindles, loosely arranged chromosomes, multiple spindles, abnormal cytokinesis, reduced cell proliferation and increased apoptosis as compared with cells transfected with its wild-type counterpart. The siRNA knock down of TRIM36 in HeLa and LN229 cells also led to reduced cell proliferation and increased apoptosis. We suggest that microtubule disruption and disorganized spindles mediated by mutant TRIM36 affect neural cell proliferation during neural tube formation, leading to APH